alexa Abstract | Evaluation of emergent and elective splenectomy cases: analysis of 129 cases

Journal of Universal Surgery
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Abstract

Background: Emergent and elective splenectomies have an important place inpractice. In this study, we aimed to emphasize the importance of splenectomy inmodern surgery and investigate our cases retrospectively.Methods and Findings: Patients who were treated by splenectomy in our clinicbetween October 2008- May 2012 were grouped into four different groups: caseswho have additional injuries in additon to splenic injury (group 1) , cases who haveno additional injuries other than splenic injuries (group 2), iatrogenic splenic injuries(group 3), elective splenectomies (group 4). These four groups were evaluated fordemographic features, etiology, surgical procedure, duration of operation, morbidityand mortality parameters.Among 129 patients 58 were females (44.9%) and 71 were males (55.1%). Meanage was 49.5 (13-82). There were 23 patients in group I (17.9 %) , 18 patients ingroup II (13.9%) , 10 patients in group III (7.7 %) , 78 patients in group IV (60.5%). In total, 123 patients were treated by conventinal splenectomy and 6 patientswere treated by laparoscopic splenectomy.Morbidity rate was 10.8 % and all have got well by medical treatment. None ofthem needed to be reoperated. One of the patients died of coagulopathy and 2patients died of multi organ dysfunction sydnrome caused by multitrauma. Mortalityrate was 2.3% .Conclusions: Timing of surgery and assessing the need for surgery has enormousimpact on the outcome of emergent and elective splenectomy cases. Conservativeapproach should be the first option in the properly equipped health care centersafter evaluating general health status of the patient, the degree of splenic injuryand presence of multiorgan injury. When splenctomy is necessary , spleen conservingstrategies should be preferred. Meticulous care should be exercised to preventiatrogenic splenic injuries. Multidisciplinary approach is the key element to reducethe mortality and morbidity rates in elective cases.

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Author(s): Enver Ilhan Mehmet Akif Ustner Ahmet Aykas Mehmet Yildirim Huseyin Toptay

Keywords

Glaucoma Surgery,Hip Surgery,Hysterectomy Surgery,Neck Surgery

 
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